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Journal and News Scan
July 31, 2020
Submitted by: Saurabh Gupta
Meta-analysis of 4 RCTs and 7 observational studies.
Observational studies suggest suggests a benefit of IV iron compared to no iron on mortality [relative risk 0.39, 95% confidence interval (CI) 0.23–0.65; P < 0.001, very low quality], units transfused per patient (mean difference −1.22, 95% CI −1.85 to −0.60; P < 0.001, very low quality), renal injury (relative risk 0.50, 95% CI 0.36–0.69; P < 0.001, very low quality) and hospital length of stay (mean difference −4.24 days, 95% CI −6.86 to −1.63; P = 0.001, very low quality).
RCTs demonstrated a reduction in the number of patients transfused with IV iron compared to oral or no iron (relative risk 0.81, 95% CI 0.70–0.94; P = 0.005, moderate quality). The pooled estimates of effect from RCTs for mortality, hospital length of stay, units transfused per patient and renal injury were consistent in direction with observational studies.
IV iron may improve postoperative morbidity in adult cardiac surgery patients with preoperative anaemia or iron deficiency. A large, rigorous, placebo-controlled, double-blinded, multicentre trial is needed to clarify the role of IV iron in this patient population.
July 22, 2020
Submitted by: Emily Robinson
This meta-analysis searched the PubMed, EMBASE, and Cochrane Library databases to investigate both fenestrated and nonfenestrated Fontan procedures, focusing on early outcomes.
July 22, 2020
Submitted by: Emily Robinson
This is a retrospective cohort analysis of more than 500 patients undergoing the David I procedure. They specifically looked into the outcome of 50 patients with bicuspid aortic valve undergoing this procedure. While the freedom from reoperation was not different between the two groups, the freedom from reoperation at 10 years was 79% in bicuspid valve patients. Unfortunately, the authors cannot provide markers of success for the David I procedure in patients with bicuspid valves, like geometric findings of the valve prior to reconstruction. However, these results are very encouraging for valve repair success in patients with bicuspid aortic valves.
July 22, 2020
Submitted by: Emily Robinson
This study assessed the association between preoperative neurologic dysfunction and postoperative neurologic injury in the diagnosis of acute type A aortic dissection.
July 15, 2020
Submitted by: Emily Robinson
This original article retrospectively analyzed the outcome of 671 patients undergoing LVAD implantation within the French multicenter ASSIST-ICD registry. While half of the patients were in cardiogenic shock and more than 20% of patients were on ECLS prior to implantation, the survival at five years is around 50%. This reflects the real world and all-comers nature of this registry and therefore provides a frank picture of LVAD outcomes in France between 2007 and 2017. Looking at their results, the authors recommend earlier referral of heart failure patients to lower the 50% rate of patients being in cardiogenic shock prior to implantation and thereby improving result of LVAD therapy in France.
July 15, 2020
Submitted by: Emily Robinson
This single-center study analyzed the aortic root replacement strategies for pediatric patients from 1995 to 2018.
July 14, 2020
Submitted by: Aristotle Protopapas
A small histopathological study of SARS and influenza autopsies compared to rejected for transplantation lungs. There is some speculation on the popular procoagulopathic nature of the panvirus, based on expression of angiotensin converting enzyme 2.There might be a collateral stimulus for lung preservation in organ retrieval.
July 10, 2020
Submitted by: Emily Robinson
The authors examined The National Cancer Database for patients who refused recommended surgery and elected stereotactic body radiation therapy (SBRT) for stage I/II non-small cell lung cancer.
July 8, 2020
Submitted by: Wei-Guo Ma
Upchurch and coauthors have recently published the practice guidelines on thoracic endovascular aneurysm repair (TEVAR) in the mangement of thoracic aortic aneurysms.
July 8, 2020
Submitted by: Wei-Guo Ma
Upchurch and coauthors have recently published the practice guidelines on thoracic endovascular aneurysm repair (TEVAR) in the mangement of thoracic aortic aneurysms.